Most Relevant Information
Provider Data
| NPI Number: | 1003568890 |
| Provider Name: | ANGELICA DIEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 9115464 |
Most Important Dates
| Enumeration Date: | 01/22/2022 |
| Last Updated: | 01/06/2023 |
Provider Practice Location
303 N CLYDE MORRIS BLVD
DAYTONA BEACH
FL
321142709
Practice Location Phone/Fax
| Phone: | 3864254000 |
| Fax: |
Provider Mailing Location
303 N CLYDE MORRIS BLVD
DAYTONA BEACH
FL
321142709
Provider Mailing Phone/Fax
| Phone: | 3864252360 |
| Fax: |